Objectives: We sought to determine whether adolescents whose favorite movie stars smoke on-screen are at increased risk of tobacco use.
Methods: During interviews, adolescent never smokers taking part in the California Tobacco Survey nominated their favorite stars. We reviewed popular films released during 1994 through 1996 to determine whether stars smoked on-screen in at least 2 films.
Results: One third of never smokers nominated a star who smoked on-screen, which independently predicted later smoking risk (odds ratio [OR] = 1.36; 95% confidence interval [CI] = 1.02, 1.82). The effect was strong among girls (OR = 1.86; 95% CI = 1.26, 2.73). Among boys, there was no independent effect after control for receptivity to tobacco industry promotions.
Conclusions: Public health efforts to reduce adolescent smoking must confront smoking in films as a tobacco marketing strategy.